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General NPI Number Information
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NPI Number | 1437397494
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Entity Type | Organization
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Legal Business Name | MINIMALLY INVASIVE COLON AND RECTAL SURGERY OF SOUTH FLORIDA PLLC
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Dates
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Enumeration Date | 01/29/2009
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Last Update Date | 03/18/2009
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Provider Practice Location Address
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Address Line | 4800 LINTON BLVD BLDG D SUITE 502B
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City | DELRAY BEACH
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State | FL
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Zip | 33445-6584
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Country | US
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Telephone | 561-381-5991
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Fax | 561-381-5275
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Provider Business Mailing Address
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Address Line | 4800 LINTON BLVD BLDG D SUITE 502B
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City | DELRAY BEACH
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State | FL
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Zip | 33445-6584
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Country | US
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Telephone | 561-381-5991
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Fax | 561-381-5275
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. AVRAHAM BELIZON
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Credential | MD
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Telephone | 561-381-5991
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | ME98306
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License Number State | FL
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